title: Psoriatic arthritis: current therapy and future directions.
abstract: BACKGROUND
  Psoriatic arthritis (PsA) once regarded as an auto-inflammatory arthritis that involves the skin is proving to be more complex with a different driver of disease process compared to rheumatoid arthritis. As growing differences emerge between PsA and rheumatoid arthritis so have the experiences and responses to therapeutics used in both disease processes.
  
  
  METHODS
  This review highlights articles of interest in the past 10 years in the OVID and PubMed database and focuses on major concepts regarding current disease-modifying anti-rheumatic drugs in PsA as well as newer target agents.
  
  
  CONCLUSIONS
  Presently, it is agreed upon that use of tumor necrosis factor inhibitors (TNFi) has greatly changed our ability to manage varying aspects of disease in PsA. However, there remain many unanswered questions in which research in PsA is mirroring RA work, these include: i) the need for outcome measures that are more specific to PsA, ii) the concept of early and treat to target, iii) the role of highly sensitive imaging, and iv) efficacy of combination therapy and further targets in those unable to tolerate or fail TNFi.
authors.affiliation: University of California, Division of Rheumatology, 9444 Medical Center Dr. Suite, La Jolla, San Diego, California, CA 92093-0943, USA. d4huynh@ucsd.edu
authors.forename: DoQuyen
authors.initials: D
authors.lastname: Huynh
authors.forename: Arthur
authors.initials: A
authors.lastname: Kavanaugh
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000627:therapeutic use; D015535:Arthritis, Psoriatic / Q000175:diagnosis / Q000188:drug therapy*; D060908:CTLA-4 Antigen / Q000037:antagonists & inhibitors; D016207:Cytokines / Q000037:antagonists & inhibitors; D006801:Humans; D010726:Phosphodiesterase Inhibitors / Q000627:therapeutic use
chemical_list: D000305:Adrenal Cortex Hormones; D000894:Anti-Inflammatory Agents, Non-Steroidal; D018501:Antirheumatic Agents; D060908:CTLA-4 Antigen; C556706:CTLA4 protein, human; D016207:Cytokines; D010726:Phosphodiesterase Inhibitors